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肥胖儿童和青少年动态血压监测与诊室血压测量的比较。

Comparison of ambulatory blood pressure monitoring and office blood pressure measurements in obese children and adolescents.

作者信息

Renda Rahime

机构信息

a Department of Pediatric Nephrology , Antalya Research and Education Hospital , Antalya , Turkey.

出版信息

Acta Clin Belg. 2018 Apr;73(2):126-131. doi: 10.1080/17843286.2017.1390536. Epub 2017 Oct 24.

Abstract

BACKGROUND

Obesity in adults has been related to hypertension and abnormal nocturnal dipping of blood pressure, which are associated with poor cardiovascular and renal outcomes. Here, we aimed to resolve the relationship between the degree of obesity, the severity of hypertension and dipping status on ambulatory blood pressure in obese children.

METHODS

A total 72 patients with primary obesity aged 7 to 18 years (mean: 13.48 ± 3.25) were selected. Patients were divided into three groups based on body mass index (BMİ) Z-score. Diagnosis and staging of ambulatory hypertension based on 24-h blood pressure measurements, obtained from ambulatory blood pressure monitoring.

RESULTS

Based on our ambulatory blood pressure data, 35 patients (48.6%) had hypertension, 7 (20%) had ambulatory prehypertension, 21 (60%) had hypertension, and 7 patients (20%) had severe ambulatory hypertension. There was a significant relationship between severity of hypertension and the degree of obesity (p < 0.05). Thirty-one patients (88.6%) had isolated nighttime hypertension, and 53 patients (73.6%) were non-dippers. All systolic blood pressure results and loads were similar between groups. Diastolic and mean arterial blood pressure levels during the night, diastolic blood pressure loads, and heart rate during the day were significantly higher in Group 3 (p < 0.05). Nocturnal non-dipping was not associated with severity of obesity.

CONCLUSION

Obesity was associated with severity of hypertension, higher diastolic blood pressure at night, mean arterial pressure at night, diastolic blood pressure loads and heart rate at day. Increase in BMI Z-score does not a significant impact on daytime blood pressure and nocturnal dipping status.

摘要

背景

成人肥胖与高血压及夜间血压异常下降有关,而这与不良的心血管和肾脏预后相关。在此,我们旨在明确肥胖儿童的肥胖程度、高血压严重程度与动态血压的下降状态之间的关系。

方法

共选取72例7至18岁的原发性肥胖患者(平均年龄:13.48±3.25岁)。根据体重指数(BMI)Z评分将患者分为三组。基于动态血压监测获得的24小时血压测量结果进行动态高血压的诊断和分期。

结果

根据我们的动态血压数据,35例患者(48.6%)患有高血压,7例(20%)患有动态血压前期,21例(60%)患有高血压,7例患者(20%)患有重度动态高血压。高血压严重程度与肥胖程度之间存在显著关系(p<0.05)。31例患者(88.6%)患有单纯夜间高血压,53例患者(73.6%)为非勺型血压者。各组间所有收缩压结果及负荷均相似。第3组夜间舒张压和平均动脉压水平、夜间舒张压负荷及白天心率显著更高(p<0.05)。夜间非勺型血压与肥胖严重程度无关。

结论

肥胖与高血压严重程度、夜间较高的舒张压、夜间平均动脉压、夜间舒张压负荷及白天心率相关。BMI Z评分的增加对白天血压和夜间血压下降状态无显著影响。

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